| NPI | 1780774513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: WA CH3034675) |
| Additional Taxonomies | 111NS0005X Chiropractor Sports Physician (Licence: OR 2962) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |